NPI 1003299082

Mary Katherine Kenney, PA

Practitioner Medical Physician Assistant Decatur, IL

Practice location

Address: 1800 E Lake Shore Dr, Decatur, IL 62521-3810
Phone: (217) 464-2966
Mailing address: 3131 N Water St, Decatur, IL 62526-2472

Registered specialties

Medical Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AM0700X Licence 085005526 (IL)

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Registry record

NPI: 1003299082
Entity type: Individual
Sex (as registered): Female
NPI issued: 8 Jul 2015
Record last updated: 13 Dec 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.